Pain Management for Chronic Back Pain

Pain Management for Chronic Back Pain

Pain, especially intractable or chronic pain, used to be something many patients simply had to learn to “live” with. In recent years, however, researchers have learned a great deal about pain and its physiological and psychological basis, leading to pain management treatments that can provide complete or partial pain relief.

Untreated pain can interfere with the healing process by affecting the immune system and leading to other undesirable results. In cases of back pain, discomfort can impede the rehabilitation process by interfering with exercise and increasing the risk of psychological distress.

This article profiles the profession of Pain Management (also called Pain Medicine) and the main approaches used to treat chronic pain.

New Understanding of Chronic Pain

Patients who report continuing pain in the absence of a definitive pathology (an identifiable, anatomical cause of the pain) are sometimes dismissed by health professionals. Even in the absence of such an identifiable cause, however, chronic pain can lead to neurological feedback processes that only serve to worsen the pain and make it more difficult to treat.

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Pain is inherently subjective, and a greater awareness of the need for taking pain seriously is growing among the health community as well as the public at large. This is particularly true for chronic back pain sufferers.

While a great majority of back pain cases are self-limiting and resolve on their own, the risk of recurrence and development of chronic disease is significant.

    Chronic back pain tends to be very difficult to treat, especially in cases involving failed back surgery or neuropathic pain (also called nerve pain).

The above considerations have led to a proliferation of services available to patients seeking both medical and alternative treatment for back pain.

What is Pain Management?

Pain management, also known as pain medicine, draws on many disciplines in science and the healing arts to systematically study pain, its prevention, evaluation, diagnosis and treatment, as well as the rehabilitation of painful disorders.

Role of Pain Management for Chronic Back Pain

In spine and musculoskeletal cases, pain management serves a variety of purposes. Pain management is usually distinguished from surgical treatment.

Pain management and the techniques it uses may be employed as follows:

  • To help identify the source of a patient's back pain
  • As an alternative to surgery, as part of an aggressive conservative (nonsurgical) care program
  • To help determine the areas to be addressed surgically
  • To help rehabilitate the patient after surgery
  • For patients after surgery to cope with residual or recalcitrant pain

Pain management uses a wide variety of techniques to address pain and painful disorders. The scientific basis for these approaches ranges from those that are completely without experimental support to those whose effectiveness has been well demonstrated in clinical trials.

In view of the diverse uses and methods of pain management and pain medicine, an overview of this fast-developing field is needed. The next page of this article highlights certain aspects of this diverse area.

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Article written by: John P. Revord, MD